Industry Zero: One man’s thought on software, business and life

No software can last forever. My first commercial rails app (revolution health’s symptom checker) has been retired. The reason for the retirement is that we want to replace one that doesn’t require paying license fee for the backend and data. The original one used rails as front end and talked to a Cold Fusion backend app (which we licensed through Mayo Clinic) through web service. Just 3 days before we retired the old app, the old symptom checker get mentioned in Rachael Ray (the TV show). Yes, very ironic. It reached its highest moment and then it died. But better die at the top then live at the bottom. Here is the segment:

My sister-in-law works for one of the big old companies.  She told me the bureaucracy and weird policy in her company.  She has to take a safe driving course (every employee have to do that) once a year because the company are afraid of lawsuit in the even if an employee get into an accident during traveling for company business.  The also installed a software called Workpace which force the user to take a break every 5 minutes.  I didn’t make this up.    The reason is that there was a lawsuit from an employee complaining about repetitive motions (I ask using a mouse or typing) causing his/her injure.   The big oil companies have too much money that they are targeted for many lawsuits.  They can’t move or change because of bureaucracy and the fear of being sued.   The only reason that they are still here is that we haven’t changed.  We still depend very much on oil.  Once that is changed.  All the big oil companies will go under.  They won’t change to an energy company which can use other energy resources beside oil.  No, they will die because they are dinosaur.  I don’t know when this will happen but I think it is going to happen within a couple of decades.

I was able to get Groovy installed on my Mac installed, up and running in no time. I can now start playing with it. It is pretty simple, just download, uppack and change two environment variables and you are good to go. The only thing about Groovy is that there aren’t many good examples or tutorial yet so show case the language. I will spend more time to play with it and see if I like it. I will also spend some time check out Grails also.

There is an article yesterday that Microsoft, Google and some other major players have agreed on EHR standard. The standard is drafted by Markle foundation’s connect for health. The standard document is here. This could be very interesting. It covers a variety of principle and guidelines on Consumer Policy and Consumer Technology. I am going to spend sometimes to read through the documents. I am sure that I will be falling into sleep but I need to read them to build a better PHR.

I ran into this website called: LimeExchange which allows company or individual to post projects and other companies or individual to bid to work on them. The idea is not new. It just add some web2.0 and social networking community features on top of it. The only thing bother me so far is that there are way more workers than employers. I only see a few projects under software development and there are over hundreds of developers registered with the sites. Another funny thing is that most of the developers are from India and the projects are also from India too.

Layoff is part of business cycle that everyone of us have to deal with. For upper management who decided the layoff, the key is to make sure you do it quick and deep enough so that you don’t have to do a second, third, fourth round in next few months. For the middle managers who didn’t get laid off, the key is to be nice to the employees who get laid off and give them whatever support they have. For employee who get laid off, the key is to realize that it is not you, it is business. A business that couldn’t afford to have you anymore. You should take this as an opportunity to move on to better or greater thing. Remember the only constant in life is change.

Personal Health Record battle is heating up. From Microsoft to Google
, and also RevolutionHealth (disclosure: I am the engineering manager for the PHR in RevolutionHealth), all trying to figure out a way to create a electronic health record system that can be managed and used by consumer, physicians and hospitals. After working on this product for awhile, I am not sure if we get to the point that we can change consumer behaviors yet. No matter how easy we can make PHR for users to use, it is still extra time that consumers needs to spend on managing it. Consumers need to see  great benefits before they are willing to manage their health records online. In fact, consumers probably don’t want to spend time to manage it. They just want to have access to it online. They will not want to import or export data between service providers. Service providers should do that for them.

I recently found this website CrimeReports.com. This website contains crime data overlaying on top of a Google map. So you can see what crimes happened at where in your neighborhood. What a great site! The best part is that their business model is not ad driven. Police department pay them to publish the data. What a cool concept!

1. Improve search by using delicious. You are not going to beat Google search doing the same thing that Google does. Do something different. Use users submitted link as part of the ranking algorithm. delicious contains tons of links. Find an algorithm that can take advantage that.
2. Integrate Flicker to Microsoft desktop.
3. Combine MSN and Yahoo into single one portal. Kill MSN.
4. Integrate Yahoo Answer to Microsoft desktop
5. Integrate Yahoo Music and come up with an iTune killer
6. Create SSO platform that will work for all websites
7. Buy ebay.

There were many efforts to create portable electronic health record and turn them into personal health record that can be controlled by users.  For example, Waltmart and a few companies are doing this thing called: Dossia.  I have been working on the similar product: https://www.revolutionhealth.com/my-health-portfolio/.  Almost everyone has this grand idea that if we can just store the health record electronically and allow them to transferred between providers and consumers, we will reduce health cost by reducing duplication of lab tests and reducing medical errors.

Sound great in theory.  The problem is how to actually convince consumers and doctors to use it.  What is the incentive for doctors to spend ton of money to put their patients record online?  So that they can easily send their patients’ records to other doctors or their patients… don’t think so.  Will electronic health records save doctor money?  Not with the existing insurance system.  Doctor would get penalize for duplicated tests.  Insurance pay for it.   Medical errors?   Insurance pay for it in case lawsuit.  How about patients?  Won’t they care?  Yes, they care about medical errors but not cost because insurance pay for it.  Furthermore, patients are not going to be able to force their doctor put their records electronically.  Nor will patient want to enter those data in themselves.

So the problem is not able providing a secure platform to store electronic health record.  The problem is that there is no business case for it under the current insurance pay system.  Unless all the insurance companies get together and say all doctors might use electronic health record by some dates in the future or the government mandate it.  We are not going to see wide use of electronic health record anytime soon.

There is another business case for electronic health record that should worth explore.  Providing health assessment, diagnosis and treatment guide based on a person’s health record.  However, how to build a business model on it is another tough problem to solve.  The key is still how you can convince doctors to spend money on it.